• Journal of the Korean Child Neurology Society
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• v.25 no.3
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• pp.204-207
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• 2017

Hyperornithinemia-hyperammonemia-homocitrullinuria syndrome (HHH syndrome) is a neurometabolic disorder with highly variable clinical severity ranging from mild learning disability to severe encephalopathy. Diagnosis of HHH syndrome can easily be delayed or misdiagnosed due to insidious symptoms and incomplete biochemical findings, in that case, genetic testing should be considered to confirm the diagnosis. HHH syndrome is caused by biallelic mutations of SLC25A15, which is involved in the urea cycle and the ornithine transport into mitochondria. Here we report a boy with spastic paraplegia and asymptomatic younger sister who have compound heterozygous mutations of c.535C>T (p.R179^*) and c.116C>A (p.T39K) in the SLC25A15 gene. We identified that p.T39K mutation is a novel pathogenic mutation causing HHH syndrome and that p.R179^*, which is prevalent in Japanese and Middle Eastern heritage, is also found in the Korean population.

• Journal of dental hygiene science
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• v.12 no.4
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• pp.404-412
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• 2012

The main object of this study is to render a better dental education to mental disabilities, teachers, and their parents. By providing a better dental education to them, mental disabilities would understand the importance of their oral hygiene. The study was held in Seoul at two different locations, named H and E mental welfare facilities. Ninety Three mental disabilities were studied by observing their oral behavior, simple oral hygiene index and plaque index prior and post to dental education. At the end of education, following result were gathered from two mental facilities. First, the level of oral behavior in Class 1,2, and 3 mental disabilities were observed prior and post to the dental education. Overall, there was no significant difference among Class 1 mental disabilities with the dental education. Second, in simple oral hygiene index, the severity of mental illness has affected on their oral behavior (F=6.322, p<.001). Third, in simple oral hygiene index, the frequency of dental education, regardless of severity of mental illness has affected on their oral hygiene (F=5.961, p<.01). Fourth, the plaque index also illustrated that the frequency of dental education, regardless of severity of dental illness has affected on their oral hygiene (F=5.126, p<.05). Finally, the general characteristics of mental disabilities according to changes in oral health awareness to gender, age, disability type, educational level do not statistically significant in all variables. Their simple oral hygiene index and plaque index advanced, although after a while they started to lose focus, which brought back their old habits. Nevertheless, in conclusion I believe that helping mental disabilities more frequently to constant reminder, will not only keep them entertained, but help them realize how important oral hygiene practice is, hopefully increasing and benefiting those with mental disabilities for future reference.

• Journal of The Korean Dental Society of Anesthesiology
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• v.7 no.2
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• pp.114-119
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• 2007

Background: Dental disabilities mean the poor cooperation for dental treatment because of patient's inherent disability, severe fear and anxiety, and communication problem. Sedation and general anesthesia are usually used for behavioral control in dentally disabled patients. In particular, sedation (conscious and deep) can help them to tolerate the proper dental treatment effectively and safely. Methods: From March 2002 to September 2007, total 35 sedation were carried out in 33 patients (male : female = 20 : 13) with dental disabilities at Seoul National University Dental Hospital and Hanyang University Medical Center. Patients' dental charts and sedation records were retrospectively reviewed. Results: Tooth extraction (19 cases) was the most common dental treatment performed under intravenous sedation (30 cases). Occasionally, inhalation sedation using Sevoflurane 1-2% was adapted (5 cases). Deep sedation (28 cases) was carried out using midazolam 2-3 mg bolus injection and propofol infusion via TCI (4.2 ${\pm}$ 0.9 mg/kg/h), and conscious sedation (7 cases) was carried out using midazolam bolus onlywithout severe complications. The duration of dental treatment was 25.5 ${\pm}$ 12.3 min and that of sedation was 43.2 ${\pm}$ 9.7 min. Conclusion: Sedation for dentally disabledpatients should be selected for effective behavioral control in conjunction with general anesthesia, considering the duration and pain-evoking potentials of dental treatment, the type and severity of patients' disabilities, and the experience of dental anesthesiologists altogether.

• Journal of Preventive Medicine and Public Health
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• v.43 no.1
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• pp.84-92
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• 2010

Objectives: To investigate the patterns of unintentional home injuries in Korea. Methods: The study population was 12,382,088 people who utilized National Health Insurance services due to injuries (main diagnosis codes S00 to T28) during 2006. Stratified samples(n=459,501) were randomly selected by sex, age group and severity of injury. A questionnaire was developed based on the International Classification of External Causes of Injury and 18,000 cases surveyed by telephone were analyzed after being projected into population proportionately according to the response rates of their strata. Domestic injury cases were finally included. Results: Domestic injuries (n=3,804) comprised 21.1% of total daily life injuries during 2006. Women were vulnerable to home injuries, with the elderly and those of lower income (medical-aid users) tending to suffer more severe injuries. Injury occurred most often due to a slipping fall (33.9%), overexertion (15.3%), falling (9.5%) and stumbling (9.4%), with severe injury most often resulting from slipping falls, falls and stumbles. Increasing age correlated with domestic injury-related disability. Conclusions: The present findings provide basic information for development of home injury prevention strategies, with focus on the elderly.

• Journal of Trauma and Injury
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• v.24 no.1
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• pp.18-24
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• 2011

Purpose: Missing cervical pathology after injury may lead to disability and influence long-term survival. Controversies continue to evolve concerning the initial screening methods used to predict cervical spine injury. Through a retrospective chart review, we attempted to analyze and propose factors predictive of cervical trauma. Methods: Of all the patients who had visited the Emergency Department of Korea University, from January 2009 to December 2009, a retrospective review of the clinical records of the 217 patients who had undergone cervical spine computed tomography was done. We investigated whether we could predict the need for cervical spine computed tomography shortly after presentation in trauma patients by comparing the group with fractures and group without fractures and by finding risk factors showing significant differences between the two groups that might be used as guides in decision making. Results: Of the 217 subjects who underwent cervical spine computed tomography scans, 33 were identified with fractures of the cervical spine while 184 were not. The most common mechanisms of trauma, in order, for those with fractures were falls, followed by traffic accidents. We found that the injury severity score, multiple injuries, a high-energy injury mechanism, neurologic deficit, and pain and tenderness of the cervical spine showed statistically significant differences between the two groups. Conclusion: Fractures of the cervical spine that are not observed with simple radiography occur with a relatively high frequency in trauma patients. Consideration should be given to the risk factors for cervical spine fracture, and if pertinent, cervical spine computed tomography should be performed with speed for early diagnosis of cervical spine fractures.

• Journal of Acupuncture Research
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• v.33 no.4
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• pp.15-31
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• 2016

Objectives : The aim of this study is to review the instruments used to assess patient condition and the effects of Korean medical treatment for patients injured in traffic accidents in clinical studies in the Korean medical field published in South Korea. Methods : A literature study was performed, and clinical studies on patients injured in traffic accidents visiting Korean medical clinics or hospitals were examined. Data about chief complaints, tools used to assess either patients' condition or the effectiveness of Korean medical treatment, and time point of assessment were extracted. The studies were classified according to symptom. The use-frequency and the parent category of the assessment tools were also analyzed. Results : 78 studies were selected and classified into 5 categories based on the chief complaints, neck pain, lower back pain, headache, psychological symptoms and unspecified symptoms. Various scales were used to report the patient's pain severity, and functional or psychological status resulting from traffic accidents. Pain index, in particular VAS, was most frequently used and a few mechanical instruments and Korean medicinal assessment tools were mentioned. Conclusion : Most instruments used in Korean medicine clinical studies on patients injured in traffic accidents are self-reported tools. To assess both the patient's condition precisely and the effectiveness of Korean medical treatment on patients injured in traffic accidents, more appropriate and unified tools should be designed that consider pain, functional disability, psychological status and objective assessments measured by devices together.

• Physical Therapy Korea
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• v.9 no.2
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• pp.61-81
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• 2002

The purposes of this research were to investigate home care rehabilitation services in rural areas and to collect basic data about disabled persons necessary when for carrying out rehabilitation services. Respondents were selected from six of a total of eight townships (Myon) and one town (Eup) in the Wonju city area. Wonju is in Kangwon Province (Do). Of a total of 338 names provided by the Myon offices, 298 persons were located and included registered and non-registered persons. Conditions included stroke, spinal cord injury, and cerebral palsy in addition to disabilities classified as first, second or third degree, in the case of registered cases. Respondent demographic characteristics, medical characteristics, rehabilitation service needs, willingness to receive rehabilitation service and individual opinions regarding rehabilitation services were analysed by frequency and percentage. The results were as follows: 1) Rehabilitation services received by disabled persons living at home in the rural areas surrounding Wonju city were medical rehabilitation (41.7%), diagnosis (36.5%), rehabilitation assistive devices (7.6%), social assistance (7.1%), rehabilitation counseling (3.0%), vocational rehabilitation (1.8%), educational rehabilitation (1.6%) and housekeeping services (0.5%). The majority of rehabilitation services were medical rehabilitation provided at hospitals and oriental medicine hospitals. 2) Sixty point eight percent of respondents expressed their willingness to receive home care rehabilitation services. Needs expressed were highest for medical rehabilitation (27.0%), followed by social assistance (19.4%), medical examination (12.4%), physician-generated diagnosis in the home setting (11.6%), sociopsychological rehabilitation (9.3%), vocational rehabilitation (7.6%), rehabilitation engineering (6.0%), educational rehabilitation (3.3%), and housekeeping services (3.3%). 3) Rehabilitation service needs were analyzed by severity classification: 65.8% of first degree, 62.7% of second degree and 55.6% of third degree disability classification, and 62.7% of non-registered disabled individuals responded that rehabilitation service was necessary. 4) Rehabilitation service needs were also analyzed by diagnosis: 62.6% of stroke, 85.5% of amputation, 60.0% of spinal cord injury and 52.4% of traumatic brain injury respondents answered positively that they were willing to receive rehabilitation service if it were to be provided. Rehabilitation service utilization data of disabled individuals living at home in rural areas were investigated and their rehabilitation needs analyzed. This critical information can be used when community-based rehabilitation programs for disabled persons living at home are planned for provision out of a public health center or when community-based rehabilitation welfare policy is formulated.

• Journal of Acupuncture Research
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• v.27 no.2
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• pp.123-142
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• 2010

Objectives : The knee pain is the main reason of getting acupuncture treatment. In order to have confidence in the results of a study, it is necessary to establish that questionnaire is both valid and reliable in questionnaire related study. The aim of this study was to review the instruments that are currently in sue for assessing the knee joint. Methods : A literature study was performed to choose appropriate scales for assessment for pain and the function of the knee. Theoretically based scales were selected for review. Therefore, 18 scales for knee and 9 scale for pain were reviewed. the status of scales involved in knee treatment of acupuncture throughout several countries was evaluated. Results & Conclusion : Lysholm Knee Scoring Scale, Cincinnati knee rating system(CKRS) are adequate for ligament injury in knee. International Knee Documentation Committee scoring system(IKDC) may become a publication requirement for journals in view of the international standing of the committee. The available outcome measure for use in osteoarthritis are Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC), Lequesne Functional Severity Index(LFI) and Knee Injury and Osteoarthritis Outcome Score(KOOS), and in rheumatoid arthritis are McMaster-Toronto Arthritis patient function preference questionnaire(MACTAR), Quality of Life-Rheumatoid Arthritis Scale(QoL-RA Scale). Visual analog scale(VAS), verbal rating scale(VRS) are commonly used for the standard pain scale. For long term follow-up study The Medical Outcomes Study Short Form-36(SF-36), Arthritis Impact Measurement Scales(AIMS), Health Assessment Questionnaire(HAQ) should be included. Each measurement has its own composition and characteristics. Their validity, reliability, responsiveness and practical characteristics were already evaluated. We found 20 domestic and 28 overseas papers about knee treatment using acupuncture assessed with knee scales.

• Journal of Korean Neurosurgical Society
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• v.62 no.5
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• pp.561-566
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• 2019

Objective : Functional outcomes have traditionally been evaluated and compared using subjective surveys, such as visual analog scores (VAS), the Oswestry disability index (ODI), and Short Form-36 (SF-36), to assess symptoms and quality of life. However, these surveys are limited by their subjective natures and inherent bias caused by differences in patient perceptions of symptoms. The Fitbit $Charge^{(R)}$ (Fitbit Inc., San Francisco, CA, USA) provides accurate and objective measures of physical activity. The use of this device in patients after laminectomy would provide objective physical measures that define ambulatory function, activity level, and degree of recovery. Therefore, the present study was conducted to identify relationships between the number of steps taken by patients per day and VAS pain scores, prognoses, and postoperative functional outcomes. Methods : We prospectively investigated 22 consecutive patients that underwent laminectomy for spinal stenosis or a herniated lumbar disc between June 2015 and April 2016 by the same surgeon. When patients were admitted for surgery and first visited after surgery, preoperative and postoperative functional scores were recorded using VAS scores, ODI scores, and SF-36. The VAS scores and physical activities were recorded daily from postoperative day (POD) 1 to POD 7. The relationship between daily VAS scores and daily physical activities were investigated by simple correlation analysis and the relationship between mean number of steps taken and ODI scores after surgery was subjected to simple regression analysis. In addition, Wilcoxon's signed-rank test was used to investigate the significance of pre-to-postoperative differences in VAS, ODI, and SF-36 scores. Results : Pre-to-postoperative VAS (p<0.001), ODI (p<0.001), SF-36 mental composite scores (p=0.009), and SF-36 physical composite scores (p<0.001) scores were found to be significantly different. Numbers of steps taken from POD 1 to POD 7 were negatively correlated with daily VAS scores (r=-0.981, p<0.001). In addition, the mean number of steps from POD 3 to POD 7 and the decrease in ODI conducted one month after surgery were statistically significant (p=0.029). Conclusion : Wearable devices are not only being used increasingly by consumers as lifestyle devices, but are also progressively being used in the medical area. This is the first study to demonstrate the usefulness of a wearable device for checking patient physical activity and predicting pain and prognosis after laminectomy. Based on our experience, the wearable device used to provide measures of physical activity in the present study has the potential to provide objective information on pain severity and prognosis.

• Korean Journal of Biological Psychiatry
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• v.25 no.3
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• pp.45-52
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• 2018

Objectives The objective of this study was to investigate the differences in sociodemographic and clinical characteristics, temperaments, and quality of life between panic disorder (PD) patients with and without major depressive disorder (PD+MDD and PD-MDD patients, respectively). Methods We compared 411 PD-MDD and 219 PD+MDD patients. All patients who were drug-free for at least 1 month were assessed at initial outpatient visits before the administration of medication. The following instruments were used for assessment: the NEO Personality Inventory-Neuroticism (NEO-N) ; the Temperament and Character Inventory-Harm Avoidance (TCI-HA) ; the State-Trait Anxiety Inventory (STAI) ; the Intolerance of Uncertainty Scale-Short (IUS); the Anxiety Sensitivity Index-Revised (ASI-R); the Beck Depression Inventory (BDI) ; the Beck Anxiety Inventory (BAI); the Penn State Worry Questionnaire (PSWQ) ; the Generalized Anxiety Disorder for 7 item (GAD-7) ; the Albany Panic and Phobia Questionnaire (APPQ) ; the Panic Disorder Severity Scale (PDSS) ; the Early Trauma Inventory Self Report-Short Form (ETISR-SF) ; the Scale for Suicidal Ideation (SSI) ; the World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF) ; the Sheehan Disability Scale (SDS) ; and the Short Form health survey (SF-36). Results Compared to the PD-MDD patients, the PD+MDD patients were younger and more likely to be unmarried. They showed higher rates of unemployment, lower levels of education and income, younger age of onset, more previous suicide attempts, a greater incidence of agoraphobia, and more previous treatments. The PD+MDD patients showed significantly higher scores on the NEO-N, the TCI-HA, the STAI, the IUS, the ASI-R, the BDI, the BAI, the PSWQ, the GAD-7, the APPQ, the PDSS, the ETISR-SF, and the SSI. In addition, the PD+MDD patients showed significantly lower quality of life than did the PD-MDD patients. In contrast with previous studies, we observed no significant differences between the two groups in terms of gender, duration until treatment, and psychiatric comorbidities. Conclusions This study showed that the PD+MDD patients have more early trauma experiences, higher levels of anxiety-related temperaments, more severe panic and depressive symptoms, and lower quality of life than the PD-MDD patients.